The phase III
CASTOR and POLLUX studies previously demonstrated benefit of daratumumab plus bortezomib and dexamethasone (DVd) or lenalidomide
and dexamethasone (DRd) vs standard-of-care (SoC) Vd or Rd regimen in relapsed
or refractory multiple myeloma (R/R MM). The latest efficacy and safety results
after 4 years of follow-up from CASTOR and POLLUX were presented at the
American Society of Hematology (ASH) 61st Meeting & Exposition 2019 held in
Orlando, Florida, US.

Pembrolizumab, used in both neoadjuvant and adjuvant settings, significantly improves pathological complete response (pCR) in patients with early triple-negative breast cancer (TNBC), according to late-breaking results of the phase III KEYNOTE-522 trial presented at the European Society for Medical Oncology (ESMO) Congress 2019.

Acalabrutinib, used in
combination with obinutuzumab or as monotherapy, improved progression-free
survival (PFS) by 80–90 percent vs chlorambucil with obinutuzumab in patients
with previously untreated chronic lymphocytic leukaemia (CLL) in the phase III
ELEVATE TN trial. The results, presented at the American Society of Haematology
61st Annual Meeting & Exposition (ASH 2019) by Dr Jeff P. Sharman of the
Willamette Valley Cancer Institute and Research Center in Eugene, Oregon, US, demonstrated
consistent PFS benefit across patient subgroups as well as tolerability of acalabrutinib
therapy.

Prof. Roger Ngan
Department of Clinical
Oncology
The University of Hong Kong

03 Apr 2020

History, presentation and management

This patient presented to the clinic at the second recurrence of the dis­ease with extensive spread of cancer within the abdomen. Since her dis­ease progressed 10 months after the last course of platinum-based che­motherapy, she was still considered platinum-sensitive.1,2She received cytoreductive surgery and hyperther­mic intraperitoneal chemotherapy, and in accordance with the Euro­pean Society for Medical Oncology (ESMO)-European Society of Gynae­cological Oncology (ESGO) recom­mendations,1she was given third-line platinum-based chemotherapy. Because the patient responded well to the platinum rechallenge, olaparib maintenance therapy was chosen.1
(Figure)

Olaparib was well tolerated in both SOLO2 and study 19.4,5Fewer than 50 percent of patients receiving olaparib required dose interruption or reduction due to adverse events (AEs); the most common grade 3 AEs were anaemia, fatigue and neutropenia.4,5Olapar­ib is now available in tablet form, which offers a reduced pill burden compared with the original 50 mg capsule formu­lation.7
It should be mentioned that the two formulations are not bioequivalent and the doses are not interchangeable: expert opinions suggest that 400 mg capsules BID may be switched to 300 mg tablet BID; and 200 mg capsules BID to 250 mg tablet BID.3,7

The present case echoes the find­ings from the clinical trials in that olapa­rib maintenance therapy prolongs disease control in a patient with recur­rent epithelial ovarian cancer. The fact that the patient has no
BRCA mutation was particularly encouraging, highlight­ing the utility of olaparib irrespective of
BRCA status. Most importantly, the patient remained well after 12 months of treatment and was able to maintain a high-quality, active lifestyle.

The phase III
CASTOR and POLLUX studies previously demonstrated benefit of daratumumab plus bortezomib and dexamethasone (DVd) or lenalidomide
and dexamethasone (DRd) vs standard-of-care (SoC) Vd or Rd regimen in relapsed
or refractory multiple myeloma (R/R MM). The latest efficacy and safety results
after 4 years of follow-up from CASTOR and POLLUX were presented at the
American Society of Hematology (ASH) 61st Meeting & Exposition 2019 held in
Orlando, Florida, US.

Pembrolizumab, used in both neoadjuvant and adjuvant settings, significantly improves pathological complete response (pCR) in patients with early triple-negative breast cancer (TNBC), according to late-breaking results of the phase III KEYNOTE-522 trial presented at the European Society for Medical Oncology (ESMO) Congress 2019.

Acalabrutinib, used in
combination with obinutuzumab or as monotherapy, improved progression-free
survival (PFS) by 80–90 percent vs chlorambucil with obinutuzumab in patients
with previously untreated chronic lymphocytic leukaemia (CLL) in the phase III
ELEVATE TN trial. The results, presented at the American Society of Haematology
61st Annual Meeting & Exposition (ASH 2019) by Dr Jeff P. Sharman of the
Willamette Valley Cancer Institute and Research Center in Eugene, Oregon, US, demonstrated
consistent PFS benefit across patient subgroups as well as tolerability of acalabrutinib
therapy.